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Revenue Management and Budget:
Works with UFHP billing and accounts receivable to resolve all departmental clinical billing and collections issues.
Assist directors in proactively identifying issues and developing strategies to maximize clinical practice operations and financial efficiency.
Utilizes a full understanding of the department’s clinical revenue cycle, including a thorough understanding of systems, processes and coding, and reimbursement and billing requirements.
Reviews and analyzes clinical collections and works with management and staff to maximize revenue cycle operations including identifying opportunities for revenue cycle improvement initiatives and development and monitoring of plans to implement process improvements.
Reviews and analyzes the clinical budget and monthly variance reports. Provide insight as to what is behind the +/- of the figures.
Performs audits by analyzing coding and reimbursement so that revenue opportunities are managed effectively and adhere to proper coding requirements.
Requires proficiency in Epic and is responsible for working with attendings, residents and APPs to ensure Epic documentation is compliant and efficient. Works with these providers to ensure all Epic SmartPhrases, SmartText, SmartLists and all other documentation meet compliance while providing the most efficient workflow for the providers.
Works with the departmental Epic Workflow Specialist to create and implement compliant Epic documentation templates across all divisions.
Develop and monitor financial, statistical and operations reports to maximize appropriate clinical revenue and minimize clinical expenses.
Manage within the clinical divisional budgets; anticipate areas of concern and communicate regularly with all concerned
Clinical Billing, Management and Compliance:
Works with the coding/scheduling teams to provide ongoing education regarding payor changes for authorization and new codes to avoid lost revenue and maximize reimbursement.
Works closely with managed care on billing issues and has a clear understanding of managed care contracts.
This position takes leadership of Billing and Accounts Receivable on resolving clinical revenue delays.
Address clinical billing issues of particular importance to the Department.
Develop a program for routine audits of departmental clinical billing to review compliance, with the results of such reviews being reported to the assistant director.
Reviews reports and/or provider progress notes for extraction of clinical billable services and applies appropriate ICD-10 and CPT codes and confirms adequate teaching of provider documentation.
Responsible for coordinating activities of the Departmental Billing Compliance Plan for Billing Compliance (billing for physician/provider professional fees). This includes but is not limited to writing policies and procedures for any billing activities undertaken by departmental personnel, education and training programs, as required by the College of Medicine Compliance office and the department.
Administrative & Business Development:
Assists with special projects, presentations, and reporting as requested.
Assist with Proformas and business development for new clinical programs and processes.
Assist director with ensuring UFHP and COM policies are implemented and service standards are met.
Assist the Director with developing strategic plans and tactics for targeted clinical growth of the divisions; perform feasibility studies; track and report on divisional progress toward goals and objectives.
Meet with new faculty to review clinical revenue cycle reports.
This position requires proficiency in Epic and is responsible for working with attendings, residents and APPs to ensure Epic documentation is compliant and efficient. Works with these providers to ensure all Epic SmartPhrases, SmartText, SmartLists and all other documentation meet compliance while providing the most efficient workflow for the providers.
Works with the departmental Epic Workflow Specialist to create and implement compliant Epic documentation templates across all divisions
10% Supervision and Training: Supervises the clinical coders which includes monitoring coder productivity, A/R trends and tracks coding and documentation issues within each division.
Works closely with faculty, fellows and the residents in the respective clinical Divisions to provide education on correct coding, proper documentation to maximize physician reimbursement, and ensure compliance with federal and state regulations.
Functions as an expert in coding surgical and evaluation and management procedures and educating faculty and staff in all areas of coding for the department.
Develop a program for ensuring and documenting that all new Department personnel, including faculty and housestaff, receive training with regard to proper documentation and billing.
Prepares and performs lectures for initiation of new residents into the coding and documentation arena.
Provides residents, faculty and APPs with feedback to improve coding.
Researches coding issues and guidelines with all available resources, including but not limited to professional associations, federal and private payer guidelines, and coding networks for accurate reporting of services and conveyance of information to faculty, residents and APPs.
Stays up to date of coding changes and provides summary updates to providers on a regular basis.
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